In a survey of 151 patients, Ampersand Health found that 87% of participants had not received external support to help manage their chronic pain and fatigue symptoms, yet it was widely sought after. Those who did seek help to manage their symptoms were mostly recommended common medical management or supplements by their GP or clinician. However, many still report ongoing symptoms impacting their quality of life.
Chronic pain and fatigue are common but complex symptoms experienced by patients with Inflammatory Bowel Disease (IBD). Both symptoms can significantly impact one’s quality of life, mental health and ability to cope with their condition.
NICE, the National Institute for Health and Care Excellence, suggested in their guidelines for managing chronic pain (2021) that Acceptance and Commitment Therapy (ACT) should be considered in a management approach for chronic pain. ACT is a new behavioural therapeutic approach that evolved from Cognitive Behavioural Therapy (CBT). With ACT, the focus shifts from ‘fixing or changing’ negative experiences to the aim of ‘living’ with them.
There has not yet been a study conducted that consists of a digitally-enabled, ACT-based app intervention to improve both chronic pain and fatigue in patients with IBD.
How was the intervention developed?
Ampersand Health’s My IBD Care app aims to help individuals self-manage their IBD through a range of tools, including but not limited to, symptom trackers and Digital Therapeutics (DTx) courses.
Upon collaboration with clinical psychologists Dr Peter Byrne and Dr Whitney Scott, it was clear that the ACT framework has had successful application when working with those with chronic pain and fatigue with IBD.
ACT guidance and activities were delivered through the 14-day DTx course, two live online sessions with a Clinical Psychologist Dr Alexa Duff, two pre-recorded videos explaining further ACT techniques and Guidebook activities that prompted the use of ACT-based skills. Furthermore, participants had access to information and worksheets about ACT
As a major part of the ACT model is taking committed action towards values, it was clear that behaviour change techniques would help the participants take action for themselves. We used 25 Behaviour Change Techniques in the design and delivery of the programme.
Ampersand’s digitally delivered 8-week support programme included live and guided access to support from a Clinical Psychologist and Health Coach, peer support sessions and in-app Digital Therapeutics built from ACT-based techniques and behavioural science.
Overall, patients’ ACT survey scores significantly improved after completing the 8-week programme (n=21, p<0.0001). The score improvement indicates that the programme successfully helped the participants to build acceptance and psychological flexibility, to feel less alone, understand more about their chronic symptoms and to live a fulfilling life despite them.
This project highlights the potential for a digitally-enabled ACT support programme to drastically improve psychological wellbeing for patients living with IBD and chronic symptoms.
88% of participants enjoyed and found value in the programme and 94% of participants reported that they learned something new from the programme.
Some quotes from participants…
“This programme has made me realise there are other ways to cope with pain and discomfort. The use of ACT and revisiting Mindfulness has given me a fresh outlook and changed my daily routine for the better.”
“The programme and ACT course helped re-focus my self-management approaches. I’m now using ACT, mindfulness and more exercise. I have less reliance and use of pain medication.”
“I have a better understanding of IBD from this programme, and I liked the regular structure of the programme.”
“I found the Care Circle webinar very informative and have made some personal changes as a direct result of that session.”
“Listening to the experts, and personal experiences of others were very helpful.”
“I loved the ACT course: so many great tips and ways to support mental health.”